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# Mefenamic Acid (Meftal-P)
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) from the fenamate class. It functions primarily as an analgesic and anti-inflammatory agent.
## Primary Indications
* Short-term management of mild to moderate pain.
* Management of primary dysmenorrhea.
## Adult Dosing
* **Pain:** 500 mg orally every 6 hours as needed.
* **Dysmenorrhea:** 500 mg orally every 6 hours as needed, usually starting with the onset of pain or bleeding.
* **Maximum Duration:** Typically not recommended for use longer than 7 days.
## Pediatric Dosing
* Mefenamic acid is **not recommended** for use in children under 14 years of age for pain management.
* For dysmenorrhea, the minimum age for use is 14 years.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Dose adjustment is not well-defined, but lower doses and careful monitoring are advised due to potential for renal toxicity.
* **Hepatic Impairment:** Use with caution. Dose adjustment is not well-defined.
## Contraindications
* Hypersensitivity to mefenamic acid, aspirin, or other NSAIDs.
* History of gastrointestinal bleeding or perforation related to previous NSAID use.
* Active peptic ulceration or history of recurrent peptic ulceration/hemorrhage.
* Severe heart failure.
* Severe renal impairment.
* Severe hepatic impairment.
* Third trimester of pregnancy.
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, constipation, dyspepsia.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; renal papillary necrosis, interstitial nephritis, renal failure; cardiovascular thrombotic events; hepatic dysfunction; hypersensitivity reactions (including anaphylaxis, Stevens-Johnson syndrome, toxic epidermal necrolysis); bronchospasm (especially in aspirin-sensitive asthmatics); hemolytic anemia.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal bleeding.
* **SSRIs/SNRIs:** Increased risk of gastrointestinal bleeding.
* **ACE inhibitors, ARBs, Beta-blockers:** Reduced antihypertensive effect, increased risk of renal impairment.
* **Diuretics:** Reduced diuretic effect, increased risk of renal impairment.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
* **Other NSAIDs/Salicylates:** Increased risk of adverse effects, particularly gastrointestinal.
## Monitoring
* Signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis).
* Renal function (BUN, creatinine).
* Liver function (LFTs).
* Blood pressure.
* Signs and symptoms of hypersensitivity reactions.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Limit use to the shortest effective duration.
* Consider gastroprotective agents (e.g., PPIs) for patients at high risk of GI complications.
* Avoid concomitant use with other NSAIDs.
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**Disclaimer:** This information is intended for healthcare professionals and is not a substitute for professional medical advice. Always verify current prescribing information with the official product monograph or a trusted drug information resource before making clinical decisions.
